With Extra Funding CARES Aims to Double OHCA Survival Rates

The Cardiac Arrest Registry to Enhance Survival (CARES), the U.S. registry that collects data on out-of-hospital cardiac arrest (OHCA), is expanding its reach across the entire United States thanks to a substantial increase in funding/support. With this expansion CARES hopes to help double the national survival rate from witnessed OHCAs by 2026.

CARES works by combining data from 9-1-1 dispatch centers, EMS providers, and receiving hospitals to create a single record for each OHCA event. The records compiled by CARES allow participating jurisdictions to assess their overall responses to OHCAs and make improvements.

Currently 26 states contribute statewide data to CARES, plus specific communities in 16 states.

To bring this total to 50 states, the American Red Cross and American Heart Association are collectively providing $500,000 annually to CARES for the next five years. Meanwhile, the U.S. Department of Health and Human Services (HHS) is fast-tracking the development of a national cardiac disease registry and telephone CPR training to 9-1-1 dispatch centers across the country.

“This collaboration will help communities measure standard OHCA outcomes and perform local improvement activities to increase survival nationally,” says Adm. Brett Giroir, MD, HHS’ assistant secretary for health. “We also commit to dramatically reducing the longstanding racial and ethnic disparities in bystander CPR performance and survival following OHCA.”

Filling a Gap 

“CARES helps a community understand how well they are dealing with OHCAs from the time the patient is treated by EMS to admission to hospital, care there, and release with or without cognitive impairments,” says Bryan McNally, MD, executive director of CARES and professor of emergency medicine at the Emory University School of Medicine’s Rollins School of Public Health. “The fact is that OHCA outcomes vary widely across the country, with many jurisdictions lacking access to longitudinal data to tell them how well they’re doing. CARES fills that gap by collecting and assessing this data for them.”

CARES was launched in 2004 through a collaboration between the Centers for Disease Control and Prevention (CDC) and the Emory University School of Medicine’s Department of Emergency Medicine. Atlanta was the first community to begin data collection, capturing nearly 600 cases in 2005.

As of 2018 CARES has collected OHCA data from more than 80,000 patients involving more than 1,200 EMS agencies and over 1,400 hospitals. To date data from more than 425,000 OHCA patients has been entered into the registry.

The medical imperative driving CARES’ expansion is very real. Every year in the U.S., about 350,000 people experience out-of-hospital cardiac arrest or sudden death—and approximately 90% who experience an OHCA die. Communities that assess their OHCA outcomes can target measures to improve their survival rates—for instance, providing dispatchers with CPR education can boost OHCA survival by guiding bystanders in emergency CPR.

“The factual and anecdotal improvements to OHCA treatment due to CARES that we are hearing about are significant,” says McNally. “CARES is helping communities improve OHCA outcomes in many parts of the country already. With this new support we hope to see these improvements go nationwide.”

For more information about the CARES registry or to enlist as an EMS system, visit mycares.net.

James Careless is a freelance writer and frequent contributor to EMS World.